Monday, March 13, 2017

EAP Utilization Hack #15: Do Outreach with Post-Heart Attack Employees and Help Them Fight Depression to Prevent Premature Death

You have probably heard me encourage EAPs to look under every nook and cranny for real opportunities to identify unaddressed behavioral risk in organizations. New ways of applying the core technology can be spotted during the year if you pay attention and listen with the "3rd ear" while engaging with supervisors, counseling employee-clients, and participating in various work organization projects. Also, subscribe to a couple workplace wellness news feeds. Personally, I like -- it hits a lot of workplace related news that EAPs should pay attention to.

Today, I was scanning press releases on wellness, and spotted new research from Intermountain Medical Center in Colorado. Research conducted by this group shows that if you have a heart attack, your chances of dying over the next 10 years are higher if you suffer from depression after the heart attack, but rehabilitation can reduce this risk.

Can you guess what the opportunity might be for applying the core technology of EAPs to risk in this situation? The opportunity is encouraging employees and their family members to meet with the EAP after they leave the hospital following a heart attack. In your office, explain support services and screen for depression, encourage rehabilitation, follow up, and also refer them as needed to psychiatric help (med management) for clinical depression.

This is ripe territory for EAPs to make a difference, and the cost-benefit of this outreach can't be under-estimated in my view. So, I am declaring this an EAP Utilization Hack #15. (See prior posts for other EAP Utilization Hacks.)

In summary, the Intermountain Medical Center Heart research team (link shown below) compiled information from 7,550 patients who completed at least two depression questionnaires over the course of one to two years. These are patients who had heart attacks.

Patients were categorized based on the results of their survey as never depressed, no longer depressed, remained depressed, or became depressed. Following each patient’s completion of the last questionnaire, patients were followed to see if they had any major cardiovascular problems such as a stroke, heart failure, heart attack or death.

At the conclusion of the study, 4.6 percent of patients who were no longer depressed had a similar occurrence of major cardiovascular complications as those who had no depression at all (4.8 percent).

Those who remained depressed, however, and those who became depressed throughout the study, had increased occurrences of major cardiovascular problems — their rates were 6 and 6.4 percent, respectively. Treatment for depression resulted in a decreased risk of cardiovascular risk that was similar to someone who didn’t have depression.

So EAPs, the strategy is to talk more about depression, how's its treated, and educate people about this brain disease. Encourage self-referral, and follow up during the year. I suggest you read these heart-related research studies on depression and its impact on cardiovascular health. See if this avenue of EAP utilization improvement doesn't make your EAP one that has greater value, and hopefully one that is less easily contracted out to managed care. You may also save a few lives along the way.